2013-02-28T13:31:36-06:00 2012-06-30 420714325 MCGLADREY LLP 201 N HARRISON STREET SUITE 300 DAVENPORT IA 528011999 990 2011-07-01 421418847 GENESIS HEALTH SYSTEM GENE 5634216508 1227 E RUSHOLME DAVENPORT IA 528032498 MARK G ROGERS 5634216508 2013-02-26 1 JOHN J ROMANO P00227323 5638884000 2011 2016-02-25 16:41:14Z MARK G ROGERS 1227 E RUSHOLME DAVENPORT IA 528032498 500375532 0 X WWW.GENESISHEALTH.COM X 1994 IA GENESIS HEALTH SYSTEM EXISTS TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED. 18 9 4642 840 1842141 6688 3964542 5572279 429053689 439256448 7986368 8889003 5725735 4797192 446730334 458514922 2535350 2524001 0 0 224745550 226001561 0 0 0 207906251 216377085 435187151 444902647 11543183 13612275 566049515 580466570 154288577 172179911 411760938 408286659 GENESIS HEALTH SYSTEM EXISTS TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED. 0 0 263868736 2472294 343780620 GENESIS HEALTH SYSTEM IS A HEALTH SYSTEM LOCATED IN EASTERN IOWA, CONSISTING OF THREE HOSPITAL FACILITIES, TWO IN DAVENPORT AND ONE IN DEWITT, IOWA. GENESIS MEDICAL CENTER-DAVENPORT, CONTAINING 502 LICENSED ACUTE BEDS. STATISTICS INCLUDE 74,476 PATIENT DAYS, 18,751 PATIENT DISCHARGES AND 179,098 OUT-PATIENT VISITS; GENESIS MEDICAL CENTER-DEWITT, CONTAINING LICENSED 13 ACUTE BEDS AND 77 SKILLED BEDS. STATISTICS INCLUDE 1,429 PATIENT DAYS, 236 PATIENT DISCHARGES, AND 18,270 OUTPATIENT VISITS. GENESIS HEALTH SYSTEM ALSO INCLUDES A FAMILY MEDICINE RESIDENCY PROGRAM THAT CONTINUES TO EDUCATE RESIDENTS IN THE HOSPITAL SETTING. 88074125 3015 73435199 GENESIS HEALTH GROUP, A PHYSICIAN GROUP WITHIN GENESIS HEALTH SYSTEM, CONSISTS OF 45 CLINICS AND 134 PHYSICIANS ENCOMPASSING A WIDE VARIETY OF SPECIALTIES AND FAMILY PRACTICE GROUPS SERVING IOWA, ILLINOIS AND SURROUNDING COMMUNITIES IN EASTERN IOWA AND WESTERN ILLINOIS. STATISTICS INCLUDE TOTAL PRACTITIONER HOURS 208,800 AND RVU'S (RELATIVE VALUE UNITS) 743,939. 20734988 48693 24830952 GENESIS AT HOME VNA & HOSPICE, A VISITING NURSE AND HOSPICE CARE PROGRAM WITHIN GENESIS HEALTH SYSTEM, ENCOMPASSES HOME HEALTH SERVICES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL/SPEECH THERAPY, SKILLED NURSING AND MEDICAL SOCIAL WORKER VISITS, AND THE HOSPICE HOUSE, WHICH CARES FOR TERMINALLY ILL PATIENTS. STATISTICS INCLUDE HOME HEALTH VISITS 123,763 AND HOSPICE/HOSPICE HOUSE DAYS 52,310. 372677849 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 574 0 1 4642 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 18 9 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 IL X MARK G ROGERS 5634216508 1227 E RUSHOLME DAVENPORT IA 528032498 STEVEN C BAHLS 4.00 X 0 0 0 MARK D BAWDEN 4.00 X X 0 0 0 GREGORY J BUSH 4.00 X X 0 0 0 CHRISTOPHER J COX 4.00 X 0 0 0 EDMUND P COYNE JR MD 4.00 X 0 0 0 DOUGLAS P CROPPER 44.00 X X 600993 0 246461 THOMAS A GILDEHAUS 4.00 X 0 0 0 ROGER J HILL 4.00 X X 0 0 0 MARK C KILMER 4.00 X 0 0 0 JAMES W KOEHLER 4.00 X 0 0 0 GEORGE J KONTOS JR MD 40.00 X 535471 0 28016 CHARLENE E MAASKE 4.00 X 0 0 0 EDWIN V MOTTO MD 10.00 X 0 0 0 EDWARD J ROGALSKI PHD 4.00 X X 0 0 0 G CHRISTOPHER WAHLIG 4.00 X X 0 0 0 C DANA WATERMAN III 4.00 X 0 0 0 CAROL A WATSON PHD RN CENP FAAN 4.00 X 0 0 0 DALE D ZUDE 4.00 X 0 0 0 MARK G ROGERS 40.00 X 307527 0 114567 WAYNE A DIEWALD 40.00 X 196923 0 0 ROBERT W FRIEDEN 40.00 X 325194 0 36395 RICHARD M KISHIUE MD 40.00 X 318350 0 49378 JULIE MANAS 40.00 X 378736 0 17946 JUDITH K PRANGER 40.00 X 352049 0 70044 FLORENCE L SPYROW 40.00 X 165795 141233 103547 NICHOLAS AUGELLI MD 40.00 X 694467 0 29207 STEVEN B BASHOR DO 40.00 X 515720 0 25541 ROBERT FIETSAM MD 40.00 X 524985 0 27549 TODD RIDENOUR MD 40.00 X 847595 0 36361 CALVIN J SLOT MD 40.00 X 479476 0 17148 JEFFREY M COOPER 40.00 X 198997 0 32221 HEIDI S KAHLY-MCMAHON 40.00 X 179576 0 73626 WILLIAM LANGLEY MD 40.00 X 342221 0 74676 ROBERT M NELSON MD 40.00 X 246631 0 54548 MIKE L SHARP 40.00 X 225679 0 72307 CRAIG SOMMERS 40.00 X 135189 0 22756 7571574 141233 1132294 205 1 1 0 METROPOLITAN MEDICAL LAB 1814 EAST LOCUST STREET DAVENPORT IA 52803 OUTSIDE SERVICES 9106176 CERNER CORPORATION PO BOX 412702 KANSAS CITY MO 64141 SOFTWARE SERVICES AGREEMENTS 5423801 MEDICUS EMERGENCY MEDICINE 7 INDUSTRIAL WAY UNIT 5 SALEM NH 03079 PHYSICIAN FEES-MED SERVICES 3205301 COGENT HEALTHCARE INC PO BOX 974451 DALLAS TX 75397 PHYSICIAN FEES-MED SERVICES 1689646 DAVENPORT SURGICAL GROUP 1228 EAST RUSHOLME STREET DAVENPORT IA 52803 OUTSIDE SERVICES 1024490 69 485340 4067529 1019410 5572279 OUTPATIENT REVENUE 621400 421742469 421742469 INPATIENT REVENUE 900099 413983481 413983481 CLINIC REVENUE 621400 129913221 129913221 HOME HEALTH & HOSPICE 621610 27895662 27895662 OTHER OPERATING REVENU 624100 6888726 5051920 1836806 -561167111 -561167111 439256448 7622353 7622353 505301 340573 164728 164728 164728 40066731 2226774 38245071 2781784 1821660 -555010 1266650 1266650 766131 493182 272949 272949 OTHER REVENUE 900099 2175845 2175845 DIETARY 900099 2068371 2063036 5335 HOUSEKEEPING 900099 115299 115299 4359515 458514922 442046771 1842141 9053731 2154328 2154328 369673 369673 4085846 1453705 2632141 374922 218002 156920 181393869 155111819 26282050 6469725 6469725 20907888 17526159 3381729 12769311 10463984 2305327 11975632 8541415 3434217 2308060 2308060 239230 239230 112785 112785 1164844 1164844 36647751 31870258 4777493 1320744 1287523 33221 40898747 37036150 3862597 7077088 831331 6245757 15017094 12229727 2787367 2071734 1257491 814243 629970 519793 110177 4167876 4167857 19 25335943 17094222 8241721 3405855 1741091 1664764 PATIENT SUPPLY COST OF 36961818 36961818 PROVISION FOR BAD DEBTS 25008208 25008208 MISCELLANEOUS 2033706 363570 1670136 444902647 372677849 72224798 0 4559542 5104363 49269864 49784716 60717960 65432437 26667288 38677310 10437231 9221836 5121663 5881067 517129637 351136973 166193212 165992664 154265413 158409749 55946811 59123202 32870531 22839226 566049515 580466570 49521584 56177867 89172645 87908923 125466 103649 15468882 27989472 154288577 172179911 X 397635264 394832463 14125674 13454196 411760938 408286659 566049515 580466570 X 13612275 -17086554 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 13000 1 64881 1 973 1 99785 178639 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PART II-B, LINE 1B, PAID STAFF OR MANAGEMENT: GENESIS HEALTH SYSTEM - IOWA HAD TWO STAFF MEMBERS INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES ARE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. PART II-B, LINE 1D, MAILINGS TO MEMBERS, LEGISLATURES, OR THE PUBLIC: EMPLOYEES OF GENESIS HEALTH SYSTEM - IOWA ARE ENCOURAGED TO PARTICIPATE IN THE IOWA HOSPITAL ASSOCIATION'S "IHA ACTION ALERTS." THE EMPLOYEES PARTICIPATE BY RESPONDING TO E-MAIL ALERTS WHICH ALLOWS THEM TO VOICE THEIR OPINIONS TO THEIR STATE REPRESENTATIVES ON HEALTHCARE RELATED MATTERS (NOT CANDIDATE-SPECIFIC). THERE IS NO DIRECT COST TO GENESIS HEALTH SYSTEM - IOWA REGARDING THIS ACTIVITY. PART II-B, LINE 1F, GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES: GENESIS HEALTH SYSTEM - IOWA PRESENTED TWO GRANTS TO OTHER ORGANIZATIONS: 1.) COALITION TO PROTECT AMERICA'S HEALTH CARE, $10,000. 2.) QUAD CITIES CHAMBER - IOWA LEGISLATIVE LUNCHEON IN JANUARY 2012, $3,000. PART II-B, LINE 1G, DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY: GENESIS HEALTH SYSTEM - IOWA HAD TWO STAFF MEMBERS INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES ARE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. THE DIRECT COSTS INCLUDED: SALARIES - $63,290, AND MILEAGE/TRAVEL EXPENSES - $1,591. PART II-B, LINE 1H, RALLIES, DEMONSTRATIONS, SEMINARS, CONVENTIONS, SPEECHES, LECTURES, OR ANY SIMILAR MEANS: ON FEBRUARY 29, 2012, GENESIS HEALTH SYSTEM - IOWA RENTED A BUS TO TRAVEL TO AND FROM DAVENPORT, IOWA, TO THE POLK COUNTY CONVENTION CENTER AND THE IOWA STATE CAPITAL. THIS TRIP ALLOWED THE LOCAL COMMUNITY TO VISIT WITH THEIR IOWA LEGISLATORS, GOVERNMENT OFFICIALS, AND THEIR STAFF. THE DIRECT COSTS INCLUDED: $973 FOR THE BUS RENTAL. PART II-B, LINE 1I, OTHER LOBBYING ACTIVITIES: IN FISCAL YEAR 2012, GENESIS HEALTH SYSTEM - IOWA RECEIVED PROFESSIONAL LOBBYING AND GOVERNMENTAL RELATIONS CONSULTING SERVICES FROM EIDE & HEISINGER, LLC AT A COST OF $25,000. LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: 23% OF MEMBERSHIP DUES TO THE IOWA HOSPITAL ASSOCIATION, OR $28,800, 25% OF MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION, OR $12,576, MEMBERSHIP DUES RELATED TO LOBBYING TO THE SCOTT COUNTY MEDICAL SOCIETY TOTALING $9,229, 65% OF MEMBERSHIP DUES TO THE AMERICAN MEDICAL ASSOCIATION, OR $7,985, AND VARIOUS OTHER ASSOCIATIONS - $16,195. 5519844 2014051 99448 100 7633243 5040858 16614 465988 3616 5519844 5010740 28352 297861 296096 5040857 5224450 30636 -243446 900 5010740 0.49980 0.50020 0.00000 0 1 1 6413038 6413038 195846913 111653233 84193680 19329398 15521130 3808268 268238588 209551891 58686697 27301700 14410719 12890981 165992664 INVESTMENT IN HEALTH ENTERPRISES OF IOWA (HEI) -3832 C INVESTMENT IN GENVENTURES, INC 24178461 C INVESTMENT IN MISERICORDIA ASSURANCE COMPANY, LTD. 120000 C INVESTMENT IN MRIOWA, LLC 227071 C INVESTMENT IN HEI COOP 1697493 C INVESTMENT IN HEI VENTURES 123008 C INVESTMENT IN HEI IOWA ECHO/ULTRASOUND 146251 C INVESTMENT IN HEI BREAST BIOPS 5676 C INVESTMENT IN HEI DIGITAL MAMMOGRAPHY 9929 C INVESTMENT IN SPRING PARK SURGERY CENTER, LLC 4439283 C INVESTMENT IN GENGASTRO, LLC 23118754 C INVESTMENT IN GENORTHO, LLC 1643312 C OTHER INVESTMENTS - GMC, DEWITT 325020 C INVESTMENT IN HEI BONE DENSITY 18972 C INVESTMENT IN GENRAD IMAGING, LLC 2973277 C INVESTMENT IN GENESIS ONCOLOGY CO-MANAGEMENT, LLC 6317 C INVESTMENT IN HEI PHARMACY SERVICES, LC 43634 C OTHER INVESTMENTS - GMC 50576 F 59123202 ACCRUED PENSION LIABILITY 26427590 ACCRUED INS TRUST LOSSES 1561882 27989472 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: GENESIS HEALTH SERVICES FOUNDATION, A RELATED ORGANIZATION, HOLDS THE ENDOWMENT FUNDS. THE INTENDED USE OF THE FOUNDATIONS ENDOWMENT FUNDS ARE AS FOLLOWS: SCHOLARSHIPS FOR EDUCATION IN THE MEDICAL FIELD, CHARITY CARE FOR THE INDIGENT AND VISITING NURSE, HOSPICE HOUSE, DIABETIC CARE, EMPLOYEE ASSISTANCE, AND PEDIATRIC HOSPICE SERVICES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: GHS IOWA, GHS ILLINOIS, THE GENESIS HEALTH SERVICES FOUNDATION, THE ILLINI HOSPITAL FOUNDATION AND THE GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST ALL FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF EACH ENTITY, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME. UNRELATED BUSINESS TAXABLE INCOME IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. FORMS 990 AND 990T FILED BY GHS IOWA, GHS ILLINOIS, THE GENESIS HEALTH SERVICES FOUNDATION, THE ILLINI HOSPITAL FOUNDATION AND THE GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 990T FILED BY GHS IOWA, GHS ILLINOIS, THE GENESIS HEALTH SERVICES FOUNDATION, THE ILLINI HOSPITAL FOUNDATION AND THE GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST ARE NO LONGER SUBJECT TO EXAMINATION FOR THE FISCAL YEARS ENDED JUNE 30, 2008 AND PRIOR. GENVENTURES, INC. IS A TAXABLE ORGANIZATION AND CURRENTLY FILES INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND VARIOUS STATE JURISDICTIONS. GENVENTURES, INC. IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS JUNE 30, 2008 AND PRIOR. FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, UNCERTAIN TAX POSITIONS HAVE REDUCED INCOME TAX EXPENSE AND HAVE INCREASED EXCESS OF REVENUE OVER EXPENSES BY NONE AND $45,000, RESPECTIVELY. FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, THERE WAS NO INTEREST EXPENSE ASSOCIATED WITH UNCERTAIN TAX POSITIONS. NO AMOUNT HAS BEEN ACCRUED FOR PENALTIES. CENTRAL AMERICAN AND THE CARIBBEAN 0 0 INVESTMENTS 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 X 1 X 1 X 1 1 0 1 1 7625151 7625151 0.01820 54390877 38240586 16150291 0.03850 0 0 62016028 38240586 23775442 0.05670 462150 462150 0.00110 2846494 1877701 968793 0.00230 5579670 4659465 920205 0.00220 235533 235533 0.00060 761490 761490 0.00180 9885337 6537166 3348171 0.00800 71901365 44777752 27123613 0.06470 5481 0 5481 0.00000 131688 0 131688 0.00030 8732 0 8732 0.00000 0 0 24583 0 24583 0.00010 8382 0 8382 0.00000 28683 0 28683 0.00010 0 0 207549 207549 0.00050 1 10243078 0 102440110 113879128 -11439018 X 1 1 1 GENGASTRO LLC AMBULATORY SURGERY CENTER 0.75000 0.00000 0.25000 2 GENORTHO LLC ORTHOPAEDIC SURGERY CENTER 0.50000 0.00000 0.50000 3 SPRING PARK SURGERY CENTER LLC OUTPATIENT SURGICAL CENTER 0.50000 0.00000 0.50000 4 GENRAD IMAGING LLC DIAGNOSTIC IMAGING CENTER 0.50000 0.00000 0.50000 5 GENESIS ONCOLOGY CO-MANAGEMENT LLC ONCOLOGY PROGRAM MANAGEMENT 0.10000 0.00000 0.90000 3 1 GENESIS MEDICAL CENTER EAST-DAVENPORT

1227 EAST RUSHOLME STREET DAVENPORT IA 52803

X X X 2 GENESIS MEDICAL CENTER WEST-DAVENPORT

1401 WEST CENTRAL PARK DAVENPORT IA 52804

X X X 3 GENESIS MEDICAL CENTER-DEWITT

1118 11TH STREET DEWITT IA 52742

X X X X GENESIS MEDICAL CENTER EAST-DAVENPORT 1 1 1 200.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 1 X 0 0 GENESIS MEDICAL CENTER WEST-DAVENPORT 2 1 1 200.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 1 X 0 0 GENESIS MEDICAL CENTER-DEWITT 3 1 1 200.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 1 X 0 0 60 GENESIS HEART INSTITUTE

1236 EAST RUSHOLME STREET DAVENPORT IA 52803

O/P CARDIAC DIAGNOSTICS & REHAB CARE VISITING NURSE ASSOC & HOSPICE HOUSE

2535 MAPLECREST ROAD BETTENDORF IA 52272

HOME HEALTH & HOSPICE MEDICAL OFFICE BUILDING #1

1228 EAST RUSHOLME STREET DAVENPORT IA 52803

O/P MAMMOGRAPHY & DIALYSIS SERVICES CENTRAL PARK MEDICAL PAVILIONS 1 & 2

1351 WEST CENTRAL PARK AVENUE DAVENPORT IA 52804

O/P CANCER, REHAB, WOUND & DR. GENESIS HEALTH GROUP

865 LINCOLN ROAD BETTENDORF IA 52722

OUTPATIENT PHYSICIAN CLINIC GENESIS IMAGING CENTER 53RD STREET

1970 E 53RD STREET DAVENPORT IA 52507

OUTPATIENT IMAGING CENTER GENESIS MEDICAL PLAZA

2535 MAPLECREST ROAD BETTENDORF IA 52722

O/P REHAB, PAIN, PHYS THERAPY & DR ILLINI LARSON CENTER

855 ILLINI DRIVE SILVIS IL 61282

OUTPATIENT LAB & PHYSICIAN CLINIC BETTENDORF IMAGING CENTER

4017 DEVILS GLEN ROAD STE 205 BETTENDORF IA 52722

OUTPATIENT RADIOLOGY SERVICES VISITING NURSE ASSOC & HOSPICE HOUSE

611 NORTH 2ND AVE CLINTON IA 52732

HOME HEALTH & HOSPICE GENESIS MEDICAL PARK

4017 DEVILS GLEN ROAD STE 100 BETTENDORF IA 52722

OUTPATIENT PHYSICIAN CLINIC DEWITT WEST WING PLACE

1118 11TH STREET DEWITT IA 52742

L-T NURSING CARE FACILITY NORTH FAMILY PRACTICE

210 WEST 53RD STREET DAVENPORT IA 52806

OUTPATIENT LAB & PHYSICIAN CLINIC DIVISION STREET CLINIC

3618 NORTH DIVISION STREET DAVENPORT IA 52804

OUTPATIENT PHYSICIAN CLINIC ELDRIDGE FAMILY PRACTICE

301 NORTH 4TH AVENUE ELDRIDGE IA 52748

OUTPATIENT LAB & PHYSICIAN CLINIC SCOTT COUNTY YMCA

3800 TANGLEFOOT LANE BETTENDORF IA 52722

OUTPATIENT REHABILITATION CLINIC CONVENIENT CARE - DAVENPORT

1520 WEST 53RD STREET DAVENPORT IA 52806

OUTPATIENT URGENT CARE CLINIC GENESIS PHYSICAL REHAB - VALLEY FAIR

2300 53RD STREET BETTENDORF IA 52722

O/P PHYSICAL THERAPY CLINIC FAMILY PRACTICE AT WEST CAMPUS

1345 WEST CENTRAL PARK AVENUE DAVENPORT IA 52804

OUTPATIENT PHYSICIAN CLINIC NORTHWEST FAMILY PRACTICE

1520 SOUTH 53RD STREET DAVENPORT IA 52806

OUTPATIENT PHYSICIAN CLINIC HEDBERG BUILDING - MOLINE FAMILY PRACTIC

2526 41ST STREET MOLINE IL 61265

OUTPATIENT PHYSICIAN CLINIC MOLINE VALLEY VIEW

615 VALLEY VIEW DRIVE MOLINE IL 61265

OUTPATIENT PHYSICIAN CLINIC GENESIS PHYSICAL REHAB - CROW VALLEY

2300 53RD AVENUE STE LL02 BETTENDORF IA 52722

O/P PHYSICAL THERAPY CLINIC GENESIS PSYCHOLOGY ASSOCIATES

4455 EAST 56TH STREET DAVENPORT IA 52804

OUTPATIENT COUNSELING CLINIC ILLINI BUILDING #1

903-05 ILLINI DRIVE SILVIS IL 61282

HOME HEALTH & O/P PHYSICIAN CLINIC ILLINI BUILDING #2

1504 10TH STREET SILVIS IL 61282

OUTPATIENT PHYSICIAN CLINIC LOMBARD PHYSICAL THERAPY

1414 WEST LOMBARD STREET DAVENPORT IA 52804

OUTPATIENT PHYSICIAN CLINIC CONVENIENT CARE - BETTENDORF

4017 DEVILS GLEN ROAD BETTENDORF IA 52722

OUTPATIENT URGENT CARE CLINIC MUSCATINE FAMILY PRACTICE

2104 CEDARWOOD STREET STE 200 MUSCATINE IA 52761

OUTPATIENT PHYSICIAN CLINIC SILVIS ANESTHESIOLOGY

801 ILLINI DRIVE SILVIS IL 61282

OUTPATIENT PHYSICIAN CLINIC GENESIS CONVENIENT CARE - ILLINOIS

2350 41ST STREET MOLINE IL 61265

OUTPATIENT URGENT CARE CLINIC DAVENPORT CLINIC

1820 WEST 3RD ST DAVENPORT IA 52803

OUTPATIENT PHYSICIAN CLINIC GENESIS PLASTIC SURGERY ASSOC

5335 EASTERN AVENUE STE C DAVENPORT IA 52804

OUTPATIENT PHYSICIAN CLINIC DEWITT FAMILY PRACTICE

1008 11TH STREET DEWITT IA 52742

HOME HEALTH, COUNSELING SERVICES, & O/P VISITING NURSE ASSOC & HOSPICE HOUSE

2546 TECH DRIVE BETTENDORF IA 52722

HOSPICE HOUSE DEWITT PAVILION 1

1118 11TH STREET DEWITT IA 52742

OUTPATIENT PHYSICAL THERAPY CLINIC ELDRIDGE PHYSICAL THERAPY

170 SOUTH 4TH AVENUE ELDRIDGE IA 52748

OUTPATIENT PHYSICAL THERAPY CLINIC GENESIS CENTER FOR BARIATRIC SURGERY

1230 EAST RUSHOLME STREET DAVENPORT IA 52803

O/P COMPREHENSIVE BARIATRIC PRGM GENESIS OCCUPATIONAL HEALTH

3319 SPRING STREET DAVENPORT IA 52807

OUTPATIENT OCCUPATIONAL HEALTH PROGRAM ROCK ISLAND INTERNAL MEDICINE

2560 24TH STREET STE 202 ROCK ISLAND IL 61201

OUTPATIENT PHYSICIAN CLINIC LECLAIRE FAMILY PRACTICE - RIVERVIEW

200 SOUTH CODY ROAD LECLAIRE IA 52751

OUTPATIENT PHYSICIAN CLINIC MOLINE VALLEY VIEW WEST FAMILY PRAC

515 VALLEY VIEW DRIVE MOLINE IL 61265

OUTPATIENT PHYSICIAN CLINIC DURANT FAMILY PRACTICE

619 5TH STREET DURANT IA 52747

OUTPATIENT PHYSICIAN CLINIC DEWITT AMBULANCE

1220 11TH STREET DEWITT IA 52742

AMBULANCE SERVICES GENESIS OCCUPATIONAL HEALTH

2350 41ST STREET MOLINE IL 61265

OUTPATIENT OCCUPATIONAL HEALTH PROGRAM GENESIS PHYSICAL THERAPY AT LECLAIRE

1003 CANAL SHORE DRIVE LECLAIRE IA 52751

OUTPATIENT PHYSICAL THERAPY CLINIC IA CITY PEDIATRIC PT CLINIC

2451 CORAL CT CORALVILLE IA 52241

OUTPATIENT PHYSICIAN CLINIC BLUE GRASS FAMILY MEDICAL

413 SOUTH MISSISSIPPI BLUE GRASS IA 52726

OUTPATIENT PHYSICAL THERAPY CLINIC ERIE FAMILY PRACTICE

530 12TH STREET ERIE IL 61205

OUTPATIENT PHYSICIAN CLINIC ALPHA FAMILY PRACTICE

202 PICARD STREET ALPHA IL 61413

OUTPATIENT PHYSICIAN CLINIC ROCK ISLAND ARSENAL FAMILY PRACTICE

1634 WHITTEMORE STE 101 ROCK ISLAND IL 61299

OUTPATIENT PHYSICIAN CLINIC MEDICAL OFFICE BUILDING #2

1230 EAST RUSHOLME STREET DAVENPORT IA 52803

OUTPATIENT PHYSICIAN CLINIC DAV OBGYN

3319 SPRING STREET DAVENPORT IA 52807

OUTPATIENT PHYSICIAN CLINIC GHS-U OF IA PEDIATRIC GASTRO

2222 53RD AVENUE BETTENDORF IA 52722

OUTPATIENT PHYSICIAN CLINIC EAP - DAVENPORT

4455 EAST 56TH STREET DAVENPORT IA 52806

COUNSELING SERVICES SILVIS SURGICAL ASSOCIATES

1801 EAST 54TH STREET DAVENPORT IA 52807

OUTPATIENT PHYSICIAN CLINIC VISITING NURSE ASSOCIATION KID'S NEST

606 WEST 2ND STREET DAVENPORT IA 52803

HOME HEALTH (MOM/ BABE PROGRAM) EAP - MUSCATINE

1605 PLAZA PLACE MUSCATINE IA 52761

COUNSELING SERVICES EAP - ROCK ISLAND

2100 18TH AVENUE ROCK ISLAND IL 61201

COUNSELING SERVICES EAP - CLINTON

1127 NORTH 2ND STREET CLINTON IA 52732

COUNSELING SERVICES PART I, LINE 3C: NOT APPLICABLE PART I, LINE 6A: NOT APPLICABLE PART I, LINE 7: GENESIS HEALTH SYSTEM UTILIZED WORKSHEET 2 TO CALCULATE ITS COST-TO-CHARGE RATIO. THE CALCULATED COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID. THE COST OF SUBSIDIZED HEALTH SERVICES WAS OBTAINED FROM GENESIS HEALTH SYSTEM'S COST ACCOUNTING SYSTEM (I.E., DECISION SUPPORT SYSTEM) THAT CALCULATES THE PER UNIT REIMBURSEMENT AND COST FOR EACH TYPE OF SERVICE AND SUPPLY THAT THE NON-MEDICARE AND NON-MEDICAID PATIENTS CONSUMED IN THE DEPARTMENTS REPORTED. COSTS OF THE "OTHER BENEFITS" (EXCLUDING SUBSIDIZED HEALTH SERVICES) REPORTED IN 7E -7I WERE COMPILED THROUGHOUT THE YEAR IN THE COMMUNITY BENEFIT DATABASE (I.E., CBISA) THAT GENESIS HEALTH SYSTEM UTILIZES. PART I, LINE 7G: NO COSTS ASSOCIATED WITH A PHYSICIAN CLINIC WERE REPORTED IN SUBSIDIZED HEALTH SERVICES. PART I, L7 COL(F): $25,008,208 OF BAD DEBT EXPENSE IS SUBTRACTED FOR PURPOSES OF COMPUTING THE PERCENTAGE IN PART I, LINE 7K, COLUMN F. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES, LESS BAD DEBT, IS 17.12%, AND THE PERCENTAGE INCREASES TO 44.24% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE. PART II: PHYSICAL IMPROVEMENTS AND HOUSING: GENESIS HEALTH SYSTEM EMPLOYEES PROMOTE THE HEALTH OF THE COMMUNITY BY SUPPORTING COMMUNITY OUTREACH PROGRAMS, INCLUDING HABITAT FOR HUMANITY, AREA SHELTERS FOR THE HOMELESS, SHELTERS FOR ABUSED WOMEN AND DEPENDENT CHILDREN, AND FOOD PANTRIES.ECONOMIC DEVELOPMENT: GENESIS HEALTH SYSTEM EXECUTIVES AND EMPLOYEES SERVE ON VOLUNTEER BOARDS THROUGHOUT THE REGION SUPPORTING IMPORTANT PROJECTS AND INITIATIVES, HOMELESS SHELTERS, MENTAL HEALTH, DOWNTOWN REDEVELOPMENT AND EVENTS AND FESTIVALS.COMMUNITY SUPPORT: GENESIS HEALTH SYSTEM PARTICIPATES IN A VOLUNTEER PARTNERSHIP WITH JUNIOR ACHIEVEMENT. SEVERAL GENESIS HEALTH SYSTEM EMPLOYEES TRAVEL TO LOCAL COMMUNITY SCHOOLS TO TEACH THE IMPORTANCE OF WORKFORCE READINESS, ENTREPRENEURSHIP, AND FINANCIAL LITERACY. GENESIS HEALTH SYSTEM CONDUCTS MULTIPLE DISASTER AND DECONTAMINATION DRILLS THROUGHOUT THE YEAR.COALITION BUILDING: GENESIS HEALTH SYSTEM EXECUTIVES AND EMPLOYEES ARE ACTIVE PARTICIPANTS IN COMMUNITY COALITIONS THAT RELATE TO IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES INCLUDE THE MAYOR'S HUNGER LUNCHEONS THAT ADDRESS THE HOMELESS POPULATION AND PARTNERSHIPS IN NURSING (PIN), A COLLABORATIVE PARTNERSHIP WITH COMMUNITY GROUPS TO IMPROVE THE COMMUNITY NURSING INFRASTRUCTURE WITH A GOAL OF IDENTIFYING AREAS OF REDUCED REPRESENTATION WHILE WORKING TO STRENGTHEN THE EDUCATIONAL AND FACULTY DEVELOPMENT TO BETTER SERVE OUR COMMUNITY AS A WHOLE. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: GENESIS HEALTH SYSTEM MAINTAINS AN ACTIVE EFFORT TO ADVOCATE FOR ACCESS TO HEALTH CARE WITH THE IOWA AND ILLINOIS STATE GOVERNMENTS AND IN WASHINGTON D.C. GENESIS EMPLOYEES PARTICIPATE IN A VOTER VOICE INITIATIVE TO ALSO ADVOCATE ON IMPORTANT HEALTH ISSUES.WORKFORCE DEVELOPMENT: GENESIS HEALTH SYSTEM PARTNERS WITH THE LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS THE HEALTH CARE WORK FORCE SHORTAGE. GENESIS HEALTH SYSTEM WORKS WITH THE LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS COMMUNITY-WIDE WORKFORCE ISSUES BY SUPPORTING JOB CREATION AND TRAINING PROGRAMS. PART III, LINE 4: PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. RECEIVABLES DUE FROM MEDICAL OFFICE BUILDING TENANTS AND FROM COMMERCIAL LAUNDRY CUSTOMERS ARE CARRIED AT THE ORIGINAL INVOICE AMOUNT LESS AN ESTIMATE MADE FOR DOUBTFUL ACCOUNTS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS, AND BY CONSIDERING THE PATIENT'S FINANCIAL HISTORY, CREDIT HISTORY AND CURRENT ECONOMIC CONDITIONS. THE SYSTEM DOES NOT CHARGE INTEREST ON PATIENT RECEIVABLES. RECEIVABLES ARE WRITTEN OFF AS BAD DEBTS WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED.THE RATIONALE AND COSTING METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE AT COST (LINE 2) CONSISTED OF MULTIPLYING THE TOTAL BAD DEBT EXPENSE PER THE INCOME STATEMENT BY THE RATIO OF PATIENT CARE COST TO CHARGES TO ARRIVE AT ESTIMATED COST OF BAD DEBT. PAYMENTS RECEIVED AFTER AN ACCOUNT HAD BEEN WRITTEN OFF TO BAD DEBT WERE CREDITED TO A BAD DEBT RECOVERY ACCOUNT. DISCOUNTS ON PATIENT ACCOUNTS PROVIDED BY THIRD-PARTY PAYERS WERE WRITTEN OFF TO A CONTRACTUAL ALLOWANCE ACCOUNT. GENESIS HEALTH SYSTEM CONTRACTS WITH AVADYNE HEALTH TO PROCESS AGING PATIENT ACCOUNTS. AVADYNE HEALTH'S COLLECTION PROCESS UTILIZES PUBLICLY AVAILABLE INFORMATION TO ENSURE ALL AGING PATIENT ACCOUNTS RECEIVE FINANCIAL ASSISTANCE IN ACCORDANCE TO GENESIS HEALTH SYSTEMS' POLICY BEFORE BEING DEEMED BAD DEBT. GENESIS HEALTH SYSTEM REPORTED ZERO DOLLARS FOR THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNT REPORTED IN PART III, LINES 5, 6, AND 7 FOR THE HOSPITALS.IN ADDITION, GENESIS HEALTH SYSTEM - IOWA CALCULATED ITS MEDICARE SHORTFALL TWO WAYS FOR SUPPLEMENTAL INFORMATIONAL PURPOSES. THESE CALCULATIONS WERE COMPUTED USING THE GROSS PATIENT REVENUE BY PAYOR MIX AND CONVERTED TO COST USING THE COST TO CHARGE RATIO FROM PART I, WORKSHEET 2. THE PAYMENT RATE WAS CALCULATED BY DIVIDING THE MEDICARE PAYMENTS BY MEDICARE CHARGES USING A 12-MONTH ZERO BALANCE REPORT. THE SHORTFALL IS THE DIFFERENCE BETWEEN THE PAYMENTS AND THE COSTS. A. THE PAYER MIX AND ZERO BALANCE REPORT FOR GENESIS MEDICAL CENTER (GMC) - DAVENPORT AND DEWITT HOSPITALS WERE USED ALONG WITH THE COST TO CHARGE RATIO CALCULATED USING EACH HOSPITAL'S DATA TO GET A "GLOBAL" COST TO CHARGE RATIO OF 35.29%, RESULTED WITH A MEDICARE SHORTFALL OF $19,127,056.-SECTION B. MEDICARE - GLOBAL (DAV & DEWITT)5. TOTAL REVENUE RECEIVED FROM MEDICARE $129,234,408 6. ALLOWABLE COSTS OF CARE $148,361,4657. SURPLUS (SHORTFALL) ($19,127,056) B. UTILIZING A PAYER MIX AND ZERO BALANCE REPORT FOR GMC-DAVENPORT HOSPITAL, DEWITT HOSPITAL, GENESIS HEALTH GROUP CLINICS, GENESIS FAMILY MEDICAL CENTER, AND VISITING NURSE ASSOCIATION, AND EACH BUSINESS UNIT'S COST TO CHARGE RATIO, CALCULATED USING WORKSHEET 2, THE COMBINED GHS - IOWA MEDICARE SHORTFALL IS $27,704,387.-SECTION B. MEDICARE - ALL INDIVIDUAL ADDED5. TOTAL REVENUE RECEIVED FROM MEDICARE $145,446,568 6. ALLOWABLE COSTS OF CARE $173,150,9557. SURPLUS (SHORTFALL) ($27,704,387)NO MEDICARE SHORTFALLS WERE INCLUDED IN COMMUNITY BENEFIT. THE MEDICARE SHORTFALL REPRESENTS THE DIFFERENCE BETWEEN THE TOTAL REVENUE RECEIVED FROM MEDICARE BASED ON MEDICARE REIMBURSEMENT RATES AND THE COSTS INCURRED BY GENESIS HEALTH SYSTEM IN PROVIDING HEALTHCARE SERVICES TO THE ELDERLY. IN 2012, THE PERCENT OF PERSONS 65 YEARS AND OVER IN ROCK ISLAND AND SCOTT COUNTIES WAS 18.6%. IN ACCORDANCE WITH GENESIS HEALTH SYSTEM'S MISSION STATEMENT, "TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED," THE ELDERLY WERE SERVED DESPITE THE MEDICARE LOSS OF $11,439,018. GENESIS HEALTH SYSTEM HAS A CLEAR MISSION TO SERVE ALL THOSE IN NEED AND TO IMPROVE THE HEALTH OF THE COMMUNITY INCLUDING THE ELDERLY. FURTHERMORE, THERE ARE NO FOR-PROFIT HOSPITALS IN THE COMMUNITY, AND THEREFORE GENESIS HEALTH SYSTEM IS ONE OF TWO TAX-EXEMPT HEALTHCARE ORGANIZATIONS IN THE COMMUNITY WHO PROVIDE ACCESS TO HEALTHCARE FOR MEDICARE PATIENTS. ACCORDINGLY, IT IS GENESIS HEALTH SYSTEM'S POSITION FOR THE REASONS STATED ABOVE THAT THE MEDICARE SHORTFALL OF $11,439,018 REPRESENTS A COMMUNITY BENEFIT. PURSUANT TO THE INSTRUCTIONS TO THE FORM 990, SCHEDULE H, THE MEDICARE SHORTFALL IS NOT INCLUDED IN PART I, LINE 7. IF THE MEDICARE SHORTFALL WAS INCLUDED IN PART I, LINE 7, THEN PART I, LINE 7K, COLUMN F WOULD BE 9.18%. PART III, LINE 9B: EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. IF ELIGIBLE, PAYMENT PLANS ARE MADE AVAILABLE BASED ON THEIR RESOURCES AND INCOME. ALL BALANCES OWING AFTER FINANCIAL ASSISTANCE ALLOWANCES HAVE BEEN TAKEN ARE PAYABLE IN MONTHLY PAYMENTS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART VI, LINE 2: GENESIS HEALTH SYSTEM UTILIZES THE COMMUNITY HEALTH ASSESSMENTS CREATED BY THE QUAD CITY HEALTH INITIATIVE (QCHI) AND THE COMMUNITY VITALITY TASK FORCE OF UNITED WAY. QCHI WAS FORMED BY GENESIS HEALTH SYSTEM, WHICH IS HEADQUARTERED IN SCOTT COUNTY, IOWA, AND TRINITY REGIONAL HEALTH SYSTEM, WHICH IS HEADQUARTERED IN ROCK ISLAND COUNTY, ILLINOIS. QCHI IS NOW A COMMUNITY PARTNERSHIP OF OVER 100 ORGANIZATIONS CONSISTING OF 500 ACTIVE INDIVIDUALS PURSUING INITIATIVES TO CREATE A HEALTHIER COMMUNITY, SERVING AS A CATALYST FOR IMPROVING THE HEALTH AND OVERALL QUALITY OF LIFE WITHIN THE QUAD CITIES. A COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS, INC., IN 2012. PART VI, LINE 3: INFORMATION ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED IN VISIBLE LOCATIONS IN THE ADMISSION DEPARTMENTS OF THE HOSPITALS. IN ADDITION, THE HOSPITAL REGISTRATION STAFF MAKE AVAILABLE INFORMATIVE BROCHURES FOR PATIENTS IN THE EMERGENCY ROOM REGISTRATION AREA EXPLAINING THEIR ELIGIBILITY FOR ASSISTANCE. GENESIS HEALTH SYSTEM PROVIDES PATIENT FINANCIAL COUNSELORS ON EACH HOSPITAL CAMPUS TO DISCUSS OPTIONS WITH THE PATIENTS. SHARED BUSINESS SERVICES PREPARES AND PROVIDES A LETTER TO EACH PATIENT, EXPLAINING THEIR CURRENT BALANCE AND ADVISING THEM OF THEIR OPTIONS. A PHONE NUMBER IS PROVIDED WITH THE LETTER ENCOURAGING THE PATIENT TO CALL IF NEEDED. IN ADDITION, THE GENESIS HEALTH SYSTEM WEBSITE ALSO LISTS THE OPTIONS FOR PAYMENT, AND ON A MONTHLY BASIS A POWER POINT PRESENTATION IS GIVEN TO INCOMING CANCER PATIENTS INFORMING THEM OF THEIR PAYMENT OPTIONS.THE OUTPATIENT PHYSICIAN CLINICS AND THE HOME HEALTH DIVISION MAKE AVAILABLE THEIR FINANCIAL POLICY BROCHURES ALONG WITH DIRECTING PATIENTS TO GOVERNMENT PROGRAMS SUCH AS SCHIP AND HAWK-I. PART VI, LINE 4: GENESIS HEALTH SYSTEM'S MISSION IS TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED. GENESIS LIVES ITS MISSION EACH AND EVERY DAY BY SERVING A 10-COUNTY REGION OF EASTERN IOWA AND WESTERN ILLINOIS, INCLUDING BOTH URBAN AND RURAL AREAS. THE REGION SERVED BY GENESIS HEALTH SYSTEM HAS A POPULATION OF 379,690. ACCORDING TO THE 2010 CENSUS, WHITES MADE UP 88.4% OF THE POPULATION WITH 8.3% BLACK OR AFRICAN-AMERICAN AND 7.6% HISPANIC OR LATINO ORIGIN.MEDIAN AGE OF THE POPULATION OF THE REGION IS 40.6 YEARS. MORE THAN 30% OF THE POPULATION OF THE REGION IS GREATER THAN 50 YEARS OLD, WHICH WILL CREATE A CONTINUED AND EXPANDED NEED FOR HEALTH CARE SERVICES IN THE NEXT 20 YEARS. THE PERCENT OF PERSONS 65 YEARS AND OVER WAS 18.6% IN ROCK ISLAND AND SCOTT COUNTIES.ACCORDING TO ESTIMATES FROM THE AMERICAN COMMUNITY SURVEY (ACS), 11.9% OF QUAD CITIES AREA RESIDENTS (SCOTT AND ROCK ISLAND COUNTIES) LIVE BELOW THE FEDERAL POVERTY. IN 2012, 2.0% OF QUAD CITIES AREA ADULTS REPORTED THAT THERE WAS A TIME IN THE PAST TWO YEARS WHEN THEY WERE LIVING ON THE STREET, IN A CAR, OR IN A TEMPORARY SHELTER. THE AVERAGE UNEMPLOYMENT RATE IN 2009 WAS 9.2% FOR ROCK ISLAND COUNTY, ILLINOIS AND 6.6% IN SCOTT COUNTY, IOWA.THE PERCENTAGE OF PEOPLE AGES 18-64 WHO DID NOT HAVE ANY HEALTH INSURANCE IN 2012 WAS 9.3% IN ROCK ISLAND COUNTY, ILLINOIS AND 11.4% IN SCOTT COUNTY, IOWA. THE QUAD CITIES AREA PERCENTAGE OF ADULTS WHO CURRENTLY SMOKED IN 2012 WAS 19.4%. THE PERCENTAGE OF ADULTS WHO WERE OBESE IN 2012 WAS 33.4% IN ROCK ISLAND COUNTY, ILLINOIS AND 33.6% IN SCOTT COUNTY, IOWA. PART VI, LINE 5: GENESIS HEALTH SYSTEM'S BOARD OF DIRECTORS IS A DIVERSE REPRESENTATION OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA THAT GENESIS HEALTH SYSTEM SERVES. GENESIS EXECUTIVES AND EMPLOYEES SERVE ON DOZENS OF VOLUNTEER BOARDS THROUGHOUT THE REGION ON IMPORTANT PROJECTS AND INITIATIVES, SUCH AS NEW LIBRARY CONSTRUCTION, HOMELESS SHELTERS, MENTAL HEALTH, DOWNTOWN REDEVELOPMENT AND EVENTS AND FESTIVALS. GENESIS EMPLOYEES SERVE THE COMMUNITIES WHERE THEY LIVE BY SERVING IN ELECTED OFFICES IN CITY AND COUNTY GOVERNMENT.GENESIS HEALTH SYSTEM EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. GENESIS HEALTH SYSTEM HAS ENDEAVORED TO IMPROVE ACCESS TO HEALTH CARE FOR THE COMMUNITIES IT SERVES BY PARTICIPATING IN APPROPRIATE JOINT VENTURES THAT OFFER NEEDED HEALTH CARE SERVICES TO UNDER-SERVED AREAS.GENESIS HEALTH SYSTEM SCHEDULES DOZENS OF HEALTH SCREENINGS AND IMMUNIZATIONS THROUGHOUT THE YEAR AT A REDUCED COST. THESE INCLUDE SCREENINGS FOR DIABETES, STROKE AND HEART DISEASE AND PUBLIC FLU IMMUNIZATION CLINICS.GENESIS HAS DONATED FUNDING FOR OUTDOOR EXERCISE COURSES CALLED GENESIS HEALTHBEAT IN DAVENPORT, IA., MOLINE, IL., AND DEWITT, IA. GENESIS IS A KEY COMMUNITY PARTNER IN DEVELOPING LET'S MOVE DAVENPORT, A GROUP FORMED IN 2010 TO PROMOTE HEALTH, FITNESS AND GOOD NUTRITION FOR CHILDREN IN DAVENPORT. THE PROGRAM INCLUDES A NUMBER OF EVENTS IN THE SPRING, SUMMER AND FALL TO GET SCHOOL CHILDREN ACTIVE. THE PROGRAM WAS PATTERNED AFTER LET'S MOVE, THE NATIONAL INITIATIVE OF FIRST LADY MICHELLE OBAMA.GENESIS HEALTH SYSTEM COLLABORATED WITH ST. AMBROSE UNIVERSITY TO BUILD A NEW HEALTH SCIENCES BUILDING ON THE GENESIS HOSPITAL CAMPUS IN DAVENPORT. BY PROVIDING EASY ACCESS TO BOTH CLASSROOM AND CLINICAL EDUCATIONS ON THE SAME SITE, GENESIS HEALTH CARE PROFESSIONALS AND ST. AMBROSE HEALTH SCIENCES STUDENTS ARE ABLE TO ADVANCE THEIR EDUCATION. PATIENTS BENEFIT FROM THE CARE PROVIDED BY ADVANCED EDUCATION NURSES AND TECHNICIANS. THE RELATIONSHIP WITH ST. AMBROSE WILL ALSO ATTRACT AND DEVELOP MORE SKILLED NURSES TO PROVIDE THE CARE THE REGION WILL NEED INTO THE FUTURE.GENESIS SPONSORS GENESIS ADVENTURES IN NURSING (GAIN), A CAMP FOR CHILDREN INTERESTED IN HEALTH CARE CAREERS. GENESIS EMPLOYEES SERVE AS MENTORS AND INSTRUCTORS DURING CAMP WEEK.GENESIS EMPLOYEES MAKE MEDICAL MISSION TRIPS EACH YEAR TO AREAS OF NEED ALL OVER THE WORLD. GENESIS EMPLOYEES, WITH THE SUPPORT OF THE HEALTH SYSTEM, HAVE PROVIDED RELIEF TO HAITI AFTER THE EARTHQUAKE AND DURING THE CHOLERA OUTBREAK AND TO TRADITIONALLY IMPOVERISHED COUNTRIES, INCLUDING PERU, ECUADOR, THE DOMINICAN REPUBLIC, HAITI AND TO AFRICAN NATIONS.GENESIS HEALTH SYSTEM HAS DONATED THOUSANDS OF DOLLARS WORTH OF MEDICAL SUPPLIES TO EMPLOYEES PARTICIPATING IN MEDICAL MISSION TRIPS AROUND THE WORLD AND EARTHQUAKE RELIEF EFFORTS IN HAITI.GENESIS AND GILDA'S CLUB OF THE QUAD CITIES SPONSOR CAMP GENESIS, A WEEK AT A LOCAL YMCA CAMP FOR CHILDREN WHO ARE DEALING WITH CANCER IN THEIR FAMILIES. KIDS WHO MAY NOT OTHERWISE HAVE THE OPPORTUNITY AS A PARENT, SIBLING OR GRANDPARENT FIGHTS CANCER ARE ABLE TO ENJOY A FREE CAMP EXPERIENCE. GENESIS EMPLOYEES SUPPORT COMMUNITY OUTREACH PROGRAMS THROUGH A PROGRAM CALLED "TAKIN IT TO THE STREETS." PROJECTS HAVE INCLUDED PRIMARY SPONSORSHIP OF A HABITAT FOR HUMANITY HOUSE (280 VOLUNTEERS); COLLECTION OF 18,000 ITEMS FOR DOMESTIC VIOLENCE SHELTERS AND HUMILITY OF MARY HOMELESS SHELTER; X-STREAM CLEANUP (85 VOLUNTEERS), A CLEANUP PROJECT OF RIVERS AND STREAMS. EMPLOYEES HAVE USED THEIR COLLECTIVE IMPACT TO SECURE DONATIONS FOR FOOD PANTRIES. IOWA GOVERNOR TERRY BRANSTAD PARTICIPATED IN A SHELTER DONATION PROJECT IN 2011. GENESIS HAS REDUCED ITS ENVIRONMENTAL FOOTPRINT ON THE COMMUNITIES IT SERVES BY IMPLEMENTING BULK WASTE RECYCLING, POLYSTYRENE RECYCLING, REDUCING SHARPS DISPOSAL, IMPLEMENTING WATER RUNOFF MEASURES, REDUCING WATER AND CHEMICAL USAGE IN THE MEDICAL LAUNDRY AND BUILDING A ROOFTOP GREEN SPACE ON A LARGE HOSPITAL ROOF IN DAVENPORT. CRESCENT LAUNDRY, A MEDICAL LAUNDRY OWNED BY A FOR-PROFIT ENTITY OF GENESIS HEALTH SYSTEM, HAS BEEN RECOGNIZED NATIONALLY FOR ITS CONSERVATION METHODS. GENESIS SPONSORS AND HOSTS A VERY POPULAR ANNUAL BOY SCOUT MERIT BADGE DAY TO ASSIST SCOUTS IN WORKING TOWARD FIRST AID AND MEDICINE MERIT BADGES. PROFESSIONAL HEALTH CARE STAFF VOLUNTEER TO INSTRUCT THE SCOUTS FOR THE DAY.GENESIS MAINTAINS AN ACTIVE EFFORT TO ADVOCATE FOR ACCESS TO HEALTH CARE IN IOWA AND ILLINOIS STATE GOVERNMENT AND IN WASHINGTON D.C. GENESIS EMPLOYEES PARTICIPATE IN A VOTER VOICE INITIATIVE TO ALSO ADVOCATE ON IMPORTANT HEALTH ISSUES WITH CITY, COUNTY, STATE AND NATIONAL ELECTED OFFICIALS. AMONG THE ADVOCACY EFFORTS IN 2011 WAS LOBBYING AGAINST A BAN ON TRAFFIC ENFORCEMENT CAMERAS IN IOWA. GENESIS HAS EXPERIENCED FEWER PATIENTS WITH TRAUMA INJURIES FROM MOTOR VEHICLE ACCIDENTS AND WILL CONTINUE TO ADVOCATE FOR PUBLIC SAFETY.GENESIS BECAME THE FOUNDING SPONSOR OF THE KOMEN QUAD CITIES RACE FOR THE CURE IN 2011 AFTER BEING INVOLVED AS A SPONSOR SINCE THE INCEPTION OF THE EVENT. THE EVENT SUPPORTS A VOUCHERS PROGRAM FOR FREE MAMMOGRAMS FROM AREA BREAST HEALTH CENTERS, INCLUDING THE KENNETH H. MCKAY CENTER FOR BREAST HEALTH AT GENESIS.EACH YEAR, GENESIS PROVIDES THE COMMUNITY WITH DOZENS OF CLASSES AND EVENTS PROMOTING HEALTH AND HEALTH EDUCATION. HUNDREDS OF RESIDENTS IN THE REGION SERVED BY GENESIS LEARN CPR, FIRST AID, PARENTING SKILLS AND NEWBORN CARE BY ENROLLING IN CLASSES AVAILABLE.SURPLUS FUNDS RESULTING FROM EFFICIENT OPERATIONS AND COST-CONTAINMENT MEASURES ARE RE-INVESTED IN THE HEALTHCARE OPERATIONS OF GENESIS HEALTH SYSTEM TO IMPROVE THE HEALTHCARE SERVICES THAT GENESIS PROVIDES. ADVANCES IN MEDICAL EQUIPMENT AND TECHNOLOGY, STAFF EDUCATION, AND NEW MEDICAL SERVICES ARE EXAMPLES OF OPERATIONAL INVESTMENTS THAT ULTIMATELY IMPROVE THE HEALTH OF THE COMMUNITIES THAT GENESIS SERVES. PART VI, LINE 6: GENESIS HEALTH SYSTEM (TAX ID #42-1418847), AN IOWA NONPROFIT CORPORATION, AND GENESIS HEALTH SYSTEM (TAX ID #36-3616314), AN ILLINOIS NOT-FOR-PROFIT CORPORATION, HAVE IDENTICAL GOVERNING BOARDS, MANAGEMENT AND BYLAWS AND CAN ACT JOINTLY.GENESIS HEALTH SYSTEM (TAX ID #42-1418847) IS ALSO THE SOLE MEMBER OF GENESIS HEALTH SERVICES FOUNDATION AND GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST, THE SOLE STOCKHOLDER OF GENVENTURES, INC., A MEMBER OF MISERICORDIA ASSURANCE COMPANY, LTD. AND A PARTNER IN GENGASTRO, LLC. GENESIS HEALTH SYSTEM (TAX ID #36-3616314) IS A PARTNER IN THE LARSON CENTER PARTNERSHIP.GENESIS HEALTH SYSTEM (TAX ID #42-1418847) OPERATES THE FOLLOWING BUSINESS UNITS TO PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES:GENESIS HEALTH SYSTEM PROVIDES ADMINISTRATIVE, MANAGEMENT, INFORMATION TECHNOLOGY AND OTHER SUPPORT SERVICES TO ITS AFFILIATES.GENESIS CLINICAL SERVICES: GENESIS HEALTH SYSTEM OWNS AND OPERATES PHYSICIAN MEDICAL PRACTICES, CONVENIENT CARE PRACTICES, OPERATES AN OCCUPATIONAL MEDICINE CLINIC AND PROVIDES BEHAVIORAL HEALTH SERVICES TO THE RESIDENTS OF EASTERN IOWA AND WESTERN ILLINOIS. GENESIS MEDICAL CENTER - DAVENPORT (GMC - DAVENPORT) IS LICENSED AS A 502-BED ACUTE CARE HOSPITAL WHICH PROVIDES SERVICES FROM TWO HOSPITAL FACILITIES LOCATED IN DAVENPORT, IOWA. GENESIS FAMILY MEDICAL CENTER (GFMC) IS A FAMILY PRACTICE RESIDENCY TRAINING PROGRAM THAT OPERATES CLINICS IN DAVENPORT AND BLUE GRASS, IOWA TO PROVIDE A CLINICAL SETTING FOR THE RESIDENTS TO TREAT PATIENTS.GENESIS MEDICAL CENTER - DEWITT (GMC - DEWITT) IS CERTIFIED AS A CRITICAL ACCESS HOSPITAL, WHICH HAS 13-ACUTE CARE AND SWING BEDS, AND HAS A 77-BED LONG-TERM CARE FACILITY, WHICH PROVIDES SERVICES FROM ITS FACILITY IN DEWITT, IOWA. GENESIS ILLINOIS PROPERTIES (GIP) OWNS LAND LOCATED IN MOLINE, ILLINOIS. DURING THE YEAR ENDED JUNE 30, 2012, GIP SOLD ITS LAND TO GENESIS MEDICAL CENTER - ILLINI AND GIP WAS DISCONTINUED AS A BUSINESS UNIT. GENESIS VISITING NURSE ASSOCIATION AND HOSPICE (VNA) PROVIDES HOME HEALTH CARE, COMMUNITY NURSING SERVICES AND HOSPICE SERVICES TO PATIENTS IN EASTERN IOWA AND WESTERN ILLINOIS.GENESIS MEDICAL CENTER - ILLINOIS (GMC - ILLINI) IS LICENSED AS A 149-BED ACUTE CARE HOSPITAL WHICH PROVIDES SERVICES FROM ITS FACILITY IN SILVIS, ILLINOIS.ILLINI HOSPITAL NURSING HOME (INH) OPERATES ILLINI RESTORATIVE CARE CENTER AND CROSSTOWN SQUARE. ILLINI RESTORATIVE CARE CENTER IS A 120-BED LICENSED NURSING FACILITY, CONSISTING OF 75 SKILLED CARE BEDS AND 45 SHELTERED CARE BEDS. TWENTY-TWO OF THE SKILLED CARE BEDS ARE DESIGNATED AS HOSPITAL-BASED MEDICARE CERTIFIED BEDS. THE SHELTERED CARE UNIT PROVIDES REHABILITATIVE AND PERSONAL CARE IN A FAMILY-ORIENTED SETTING. CROSSTOWN SQUARE IS AN INDEPENDENT LIVING FACILITY CONTAINING 76 RENTABLE APARTMENTS AND TWO GUESTROOMS THAT OFFERS SERVICES DESIGNED TO MEET THE NEEDS OF OUR SENIOR ADULTS. GENESIS HEALTH SYSTEM IOWA AND GENESIS HEALTH SYSTEM ILLINOIS HAVE A CONTROLLING OWNERSHIP INTEREST OR MEMBERSHIP IN THE FOLLOWING ORGANIZATIONS: GENESIS HEALTH SERVICES FOUNDATION (GENESIS FOUNDATION) IS AN ORGANIZATION WHOSE MISSION IS TO DEVELOP, MANAGE AND GRANT CHARITABLE SUPPORT TO MEET THE HEALTH-RELATED NEEDS OF THE COMMUNITIES SERVED BY GENESIS HEALTH SYSTEM. THE GENESIS FOUNDATION IS REFERRED TO AS THE FOUNDATION.ILLINI HOSPITAL FOUNDATION (ILLINI FOUNDATION) SUPPORTS GMC - ILLINI BY PROVIDING FINANCIAL AND FUNDRAISING ASSISTANCE. THE MISSION OF THE ILLINI FOUNDATION IS TO ASSIST GMC - ILLINI IN PROVIDING QUALITY, COMPASSIONATE CARE FOR ALL THOSE IN NEED BY RAISING, MANAGING AND GRANTING CHARITABLE FUNDS. DURING THE YEAR ENDED JUNE 30, 2012, ILLINI FOUNDATION MERGED WITH GENESIS FOUNDATION AND ILLINI FOUNDATION WAS DISSOLVED.THE LARSON CENTER PARTNERSHIP (LCP) IS A FOR-PROFIT REAL ESTATE PARTNERSHIP WHICH OWNS A MEDICAL OFFICE BUILDING ADJACENT TO GMC - ILLINI AND LEASES SPACE FOR CLINICS, LABORATORY, PHARMACY AND OFFICES TO GMC - ILLINI AND OTHER THIRD-PARTY ORGANIZATIONS. GHS ILLINOIS IS A GENERAL PARTNER AND OWNS APPROXIMATELY 75.6% OF LCP.GENVENTURES, INC. (GENVENTURES) IS A WHOLLY-OWNED FOR-PROFIT CORPORATION WHICH OPERATES THE FOLLOWING DIVISIONS, PRIMARILY IN THE QUAD CITIES:GENESIS AT HOME, CONTINUING CARE SELLS AND LEASES HOME MEDICAL EQUIPMENT; PROVIDES INTRAVENOUS THERAPY SERVICES, INCLUDING SALES OF RELATED SOLUTIONS AND SUPPLIES TO PATIENTS; AND PROVIDES RETAIL PHARMACEUTICAL AND OVER-THE-COUNTER PRODUCTS TO PATIENTS AND EMPLOYEES OF THE SYSTEM.GENPROPERTIES OWNS, LEASES AND/OR MANAGES OFFICE SPACE IN 14 MEDICAL OFFICE BUILDINGS LOCATED IN DAVENPORT, ELDRIDGE, LECLAIRE, MUSCATINE AND BETTENDORF, IOWA.CRESCENT LAUNDRY PROVIDES COMMERCIAL LAUNDRY SERVICES TO HEALTH CARE FACILITIES IN EASTERN IOWA AND IN NORTH-CENTRAL ILLINOIS.GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST (WORKERS' COMPENSATION TRUST) PROVIDES A FUND WHICH CAN BE USED TO PAY WORKERS' COMPENSATION CLAIMS AND COSTS FOR THE BENEFIT OF GENESIS HEALTH SYSTEM.MISERICORDIA ASSURANCE COMPANY, LTD. (MISERICORDIA) IS A WHOLLY-OWNED CAYMAN BASED CAPTIVE INSURANCE COMPANY WHICH UNDERWRITES THE GENERAL AND PROFESSIONAL LIABILITY RISKS OF GENESIS HEALTH SYSTEM AND AFFILIATES.GENGASTRO, LLC (D/B/A THE CENTER FOR DIGESTIVE HEALTH) IS A LIMITED LIABILITY COMPANY, WHICH WAS FORMED IN 2003, A SINGLE-SPECIALTY GASTROENTEROLOGY AMBULATORY SURGERY CENTER LOCATED IN BETTENDORF, IOWA. IN DECEMBER 2010, GENESIS HEALTH SYSTEM ACQUIRED AN ADDITIONAL 16.67% INTEREST IN GENGASTRO AND MAINTAINED A 66.67% OWNERSHIP INTEREST AS OF JUNE 30, 2011. UPON OBTAINING A CONTROLLING INTEREST, THE SYSTEM CONSOLIDATED THE ACCOUNTS OF GENGASTRO, LLC IN ITS CONSOLIDATED FINANCIAL STATEMENTS IN JANUARY 2011. DURING THE YEAR ENDED JUNE 30, 2012, GENESIS HEALTH SYSTEM ACQUIRED AN ADDITIONAL 8.33% INTEREST IN GENGASTRO, LLC FROM NONCONTROLLING INTERESTS AND MAINTAINS A 75% OWNERSHIP INTEREST AS OF JUNE 30, 2012.DAVENPORT SRS LEASING, LLC (SRS) IS A LIMITED LIABILITY COMPANY, WHICH WAS FORMED IN 2008, WHICH LEASES MEDICAL EQUIPMENT. GENESIS HEALTH SYSTEM MAINTAINED A 93.75% OWNERSHIP INTEREST AS OF JUNE 30, 2011. DURING THE YEAR ENDED JUNE 30, 2012, GMC - DAVENPORT ACQUIRED THE REMAINING INTEREST OF SRS, TO OBTAIN 100% OWNERSHIP. UPON OBTAINING 100% OWNERSHIP, THE ASSETS, LIABILITIES AND OPERATIONS OF SRS WERE TRANSFERRED TO GMC - DAVENPORT AND SRS WAS DISSOLVED.GENESIS ACCOUNTABLE CARE ORGANIZATION, LLC (GENESIS ACO): THE GENESIS ACO IS AN IOWA LIMITED LIABILITY COMPANY FORMED IN DECEMBER 2011. ITS PURPOSE IS TO ENGAGE IN ANY LAWFUL BUSINESS AND ANY BUSINESS RELATED TO CREATION AND ORGANIZATION OF A "PHYSICIAN-DRIVEN" NETWORK TO ACT AS, AND/OR PARTICIPATE IN, AN ACCOUNTABLE CARE ORGANIZATION WITHIN THE MEANING OF THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT. THE COMPANY IS ALSO ORGANIZED TO DEVELOP A CLINICALLY INTEGRATED NETWORK OF PROVIDERS INCLUDING PHYSICIANS, HEALTH PROFESSIONALS, HOSPITALS AND ANCILLARY PROVIDERS WORKING TOGETHER TO PROMOTE HIGH QUALITY, COORDINATED AND EFFICIENT CARE TO PATIENTS INCLUDING MEMBERS OF VARIOUS MANAGED CARE PAYORS AND THE COMMUNITY AT LARGE. THE GENESIS ACO HAD NO FINANCIAL ACTIVITY DURING THE YEAR ENDED JUNE 30, 2012. REPORTS FILED WITH STATES PART VI, LINE 7 IL,IA 1 GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN & TRUST 1227 EAST RUSHOLME STREET DAVENPORT IA 52803 391905171 501(C)(3) 617163 CLAIM PAYMENTS GENESIS HEALTH SERVICES FOUNDATION 1227 EAST RUSHOLME STREET DAVENPORT IA 52803 421421670 501(C)(3) 186422 11175 FMV ADVERTISING SPACE IN THE QC TIMES & DISPATCH/ARGUS NEWPAPERS. HEALTHCARE RELATED CONTRIBUTIONS; GOLF CHALLENGE SPONSORSHIP BALLET QUAD CITIES 613 17TH STREET ROCK ISLAND IL 61201 421366753 501(C)(3) 7000 SEASONAL SPONSORSHIP BIX-7 - QUAD CITY TIMES 2685 E KIMBERLY ROAD BETTENDORF IA 52722 420823980 40000 SPONSORSHIP FOR BIX RACE DAVENPORT ONE 130 WEST SECOND STREET DAVENPORT IA 52801 421500610 501(C)(6) 50000 SPONSORSHIP - RED, WHITE, & BOOM; BEAUTIFICATION PROJECT - DOWNTOWN STREETSCAPE, IA/IL LEGISLATIVE FORUMS, QC CAMPAIGNS SCOTT COUNTY FAMILY Y 606 WEST 2ND STREET DAVENPORT IA 52801 420703278 501(C)(3) 25500 SPONSORSHIP FOR CAMP GENESIS AND PARTNER WITH YOUTHS ST AMBROSE UNIVERSITY 518 WEST LOCUST STREET DAVENPORT IA 52804 420703280 501(C)(3) 218000 CONTRIBUTION TOWARDS HEALTH SCIENCE BUILDING TAPE2TAPE SPORTS & ENTERTAINMENT - QC MALLARDS 1201 RIVER DRIVE MOLINE IL 61265 364704618 36000 2012 SPONSORSHIP COMMUNITY HEALTH CARE 500 W RIVER DRIVE DAVENPORT IA 52801 421060724 501(C)(3) 50000 DONATION TO ORGANIZATION THAT AIDS INDIVIDUALS WHO DO NOT HAVE MEDICAL OR DENTAL COVERAGE DEWITT AREA FOUNDATION PO BOX 260 DEWITT IA 52742 421296691 501(C)(3) 50000 2012 STAR PLEDGE, ARTS & RECREATION RICK'S HOUSE OF HOPE 1227 EAST RUSHOLME STREET DAVENPORT IA 52803 241914034 501(C)(3) 19500 SEASONAL SPONSORSHIP GILDA'S CLUB QUAD CITIES 1234 E RIVER DRIVE DAVENPORT IA 52803 421446989 501(C)(3) 33200 SPONSORSHIP FOR CAMP GENESIS PUTNAM MUSEUM 1717 WEST 12TH STREET DAVENPORT IA 52804 420680474 501(C)(3) 25000 SPONSORSHIP FOR DINOSAURS UNLEASHED PROGRAM RIVERCENTER 136 EAST THIRD STREET DAVENPORT IA 52801 421463763 5000 SPONSORSHIP FOR RIVERDANCE I WIRELESS CENTER 1201 RIVER DRIVE MOLINE IL 61265 363482673 20000 SPONSORSHIP: VIDEOWALL/ESCROW & SKATING FIGGE ART MUSEUM 225 W 2ND ST DAVENPORT IA 52801 426090398 501(C)(3) 5000 SPONSORSHIP FOR FINS AND FEATHERS EXHIBIT SUSAN G KOMEN BREAST CANCER 5005 LBJ FREEWAY DALLAS TX 75244 751835298 501(C)(3) 37749 SPONSORSHIP FOR RACE FOR THE CURE UNIVERSITY OF IOWA MEDICAL SERVICE PLAN 200 HAWKINS DRIVE IOWA CITY IA 52242 426004813 501(C)(3) 20000 CONTRIBUTION TOWARD PUBLIC HEALTH BUILDING WQAD- TV 3313 SOLUTIONS CENTER CHICAGO IL 60677 208614101 17500 SPONSORSHIP FOR TERRY SWAILS CHILDREN'S BOOK QUAD CITIES BICYCLE CLUB 2833 KELLING STREET DAVENPORT IA 52804 421074130 501(C)(4) 10000 SPONSORSHIP FOR THE CRITERIUM MEMORIAL DAY BIKE RACES QUAD CITY SYMPHONY 327 BRADY STREET DAVENPORT IA 52801 426017663 501(C)(3) 10000 SPONSORSHIP OF SUPPORT POEMS AND FATE CONCERT QUAD CITIES RIVER BANDITS 209 GAINES ST DAVENPORT IA 52801 113804992 5250 SPONSORSHIP FOR SEASONAL EVENTS DURING THE BANDIT'S GAMES AMERICAN HEART ASSOCIATION 460 LINDBERGH BLVD ST LOUIS MO 63141 135613797 501(C)(3) 5000 HEART WALK 2012 SPONSORSHIP IOWA - ILLINOIS HIGH SCHOOL BASKETBALL SHOOTOUT LTD 516 EAST DOVER COURT DAVENPORT IA 52803 830413194 501(C)(3) 6000 SPONSORSHIP - POWER SPORTS PERFORMANCE SHOOTOUT EVENT 16 8 MEDICAL SUPPLIES TO INDIVIDUALS 1244 88512 FAIR MARKET VALUE MEDICAL SUPPLIES GRANTS FOR RESEARCH STUDIES 186 281161 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE GENESIS HEALTH SYSTEM - IOWA STAFF REQUIRES RECEIPTS AND OTHER DOCUMENTATION PRIOR TO RELEASING FUNDS FOR PROJECTS AND SERVICES WITHIN THE SCOPE OF THE ORGANIZATION'S MISSION. PROPER AUTHORIZATION OF GRANT REQUESTS IS ALSO REQUIRED. STAFF FOLLOWS THE ORGANIZATION'S FUNDING ADMINISTRATIVE POLICY TO ENSURE THAT GRANTS ARE BEING APPROVED AND UTILIZED CORRECTLY. X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 DOUGLAS P CROPPER 560169 0 0 0 40824 0 222056 0 24405 0 847454 0 0 0 GEORGE J KONTOS JR MD 494699 0 0 0 40772 0 9800 0 18216 0 563487 0 0 0 MARK G ROGERS 254279 0 0 0 53248 0 101521 0 13046 0 422094 0 0 0 WAYNE A DIEWALD 21903 0 175000 0 20 0 0 0 0 0 196923 0 0 0 ROBERT W FRIEDEN 230319 0 0 0 94875 0 15894 0 20501 0 361589 0 0 0 RICHARD M KISHIUE MD 278651 0 0 0 39699 0 40245 0 9133 0 367728 0 0 0 JULIE MANAS 190053 0 0 0 188683 0 7157 0 10789 0 396682 0 0 0 JUDITH K PRANGER 183585 0 0 0 168464 0 57689 0 12355 0 422093 0 89919 0 FLORENCE L SPYROW 152780 130146 0 0 13015 11087 54690 46588 1225 1044 221710 188865 0 0 NICHOLAS AUGELLI MD 655608 0 0 0 38859 0 12250 0 16957 0 723674 0 0 0 STEVEN B BASHOR DO 450368 0 10952 0 54400 0 2450 0 23091 0 541261 0 0 0 ROBERT FIETSAM MD 503942 0 0 0 21043 0 9800 0 17749 0 552534 0 0 0 TODD RIDENOUR MD 807091 0 0 0 40504 0 17150 0 19211 0 883956 0 0 0 CALVIN J SLOT MD 426035 0 29700 0 23741 0 7869 0 9279 0 496624 0 0 0 JEFFREY M COOPER 136632 0 0 0 62365 0 11265 0 20956 0 231218 0 0 0 HEIDI S KAHLY-MCMAHON 161960 0 0 0 17616 0 55206 0 18420 0 253202 0 0 0 WILLIAM LANGLEY MD 221240 0 0 0 120981 0 58509 0 16167 0 416897 0 0 0 ROBERT M NELSON MD 178775 0 0 0 67856 0 38686 0 15862 0 301179 0 0 0 MIKE L SHARP 143246 0 0 0 82433 0 57390 0 14917 0 297986 0 39942 0 CRAIG SOMMERS 119500 0 0 0 15689 0 5529 0 17227 0 157945 0 0 0 PART I, LINE 1A GENESIS HEALTH SYSTEM PROVIDES THE FOLLOWING TO INDIVIDUALS REPORTED IN PART VII, SECTION A, LINE 1A: TRAVEL FOR COMPANIONS: THIS BENEFIT IS OFFERED TO ALL EMPLOYEES. THE ORGANIZATION REQUIRES REIMBURSEMENT OF THESE EXPENSES DIRECTLY TO THE ORGANIZATION. GROSS-UP PAYMENTS: THIS BENEFIT IS OFFERED TO QUALIFYING EXECUTIVES WHO HAD CONTRIBUTIONS MADE ON THEIR BEHALF IN THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. CONTRIBUTIONS TO THE PLAN ARE INCLUDED WITH REPORTABLE COMPENSATION FOR INDIVIDUALS WITH VESTED CONTRIBUTIONS. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT SAVING BENEFIT PLAN IN 2011 SPONSORED BY GENESIS HEALTH SYSTEM - IOWA: JEFFREY M. COOPER- $46,637, ROBERT W. FRIEDEN - $80,498, WILLIAM LANGLEY, M.D. - $66,768, ROBERT M. NELSON, M.D. - $ 26,086, JUDITH K. PRANGER - $142,899 AND MIKE L. SHARP - $60,684. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GENESIS HEALTH SYSTEM - IOWA ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2011. THIS INFORMATION IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. THE FOLLOWING INDIVIDUALS ALSO PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT SAVINGS BENEFIT PLAN IN 2011 SPONSORED BY GENESIS HEALTH SYSTEM - IOWA: DOUGLAS P. CROPPER - $212,256, HEIDI S. KAHLY-MCMAHON - $44,290, RICHARD M. KISHIUE, M.D. - $25,545, ROBERT M. NELSON, M.D. - $26,086, MARK G. ROGERS - $88,100, MIKE L. SHARP - $19,093, AND FLORENCE L. SPYROW - $91,478. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GENESIS HEALTH SYSTEM - IOWA ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2011. THIS INFORMATION IS INCLUDED IN DEFERRED COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. SUPPLEMENTAL INFORMATION PART III PART II, COLUMN F: THE FOLLOWING INDIVIDUALS ALSO PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT SAVINGS BENEFIT PLAN IN 2009, 2010, AND 2011 SPONSORED BY GENESIS HEALTH SYSTEM - IOWA: JUDITH K. PRANGER - $89,919 AND MIKE L. SHARP - $39,942. THE DOLLAR AMOUNT REPRESENTS THE PRIOR YEAR CONTRIBUTIONS MADE BY GENESIS HEALTH SYSTEM - IOWA ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2009 AND 2010. THIS INFORMATION WAS INCLUDED IN DEFERRED COMPENSATION ON THE PRIOR YEARS' FORM 990, PART VII AND SCHEDULE J, PART II. THESE INDIVIDUALS REACHED A SPECIFIED LEVEL OF VESTING IN 2011, SO THE DOLLAR AMOUNT IS NOW INCLUDED IN REPORTABLE COMPENSATION ON THE CURRENT YEAR FORM 990, PART VII AND SCHEDULE J, PART II. THE DOLLAR AMOUNT IS ALSO LISTED AS COMPENSATION REPORTED IN PRIOR FORM 990 ON THE CURRENT YEAR FORM 990, SCHEDULE J, PART II. IOWA FINANCE AUTHORITY 521699886 46246PLP4 2010-06-24 95545195 REFUND 12-23-97 AND 08-02-00 BOND ISSUE; RENOVATE AND EQUIP FACILITY 0 0 0 5605000 95545195 1367299 23389253 2010 1 0 1 1 0 0 1 1 1 1 0.00910 0.00000 0.00910 1 0 0 0 0 0 1 X WELLMARK HEALTH PLAN OF IOWA INC SEE BELOW IN PART V 84905790 GENESIS HEALTH SYSTEM (GHS) HAS A PROVIDER SERVICE AGREEMENT FOR PATIENT MEDICAL SERVICES AND RECEIVES ADDITIONAL INCOME FOR QUALITY HEALTHCARE SERVICES FROM WELLMARK HEALTH PLAN OF IOWA, INC. 0 GENVENTURES INC SEE BELOW IN PART V 26096484 GENVENTURES, INC. PAID GHS AS A COMMON PAYMASTER AND REIMBURSEMENT OF INTEREST. 0 GENVENTURES INC SEE BELOW IN PART V 24119221 GHS PAID GENVENTURES, INC. FOR LEASE PAYMENTS, MEDICAL SUPPLIES, AND LAUNDRY SERVICES. 0 WELLMARK HEALTH PLAN OF IOWA INC SEE BELOW IN PART V 23438126 GHS OBTAINS EMPLOYEE HEALTH INSURANCE COVERAGE AND ISSUES REFUNDS FOR OVERPAYMENTS TO WELLMARK HEALTH PLAN OF IOWA, INC. 0 NAVIGANT CONSULTING INC SEE BELOW IN PART V 3201661 GHS USES SERVICES PROVIDED BY NAVIGANT CONSULTING, INC. 0 LARSON CENTER PARTNERSHIP SEE BELOW IN PART V 1252644 FACILITY LEASE PAYMENTS 0 BUSH CONSTRUCTION COMPANY INC SEE BELOW IN PART V 234667 GHS USES SERVICES PROVIDED BY BUSH CONSTRUCTION. COMPANY, INC. 0 HEALTH ENTERPRISES SEE BELOW IN PART V 158009 HEALTH SUPPORT SERVICES 0 QUAD CITY BANK & TRUST MARK KILMER IS THE CHAIRMAN OF QCB&T, AND A DIRECTOR OF GHS. 150186 GHS USES SERVICES PROVIDED BY QUAD CITY BANK & TRUST. 0 EDWARD TED J ROGALSKI EDWARD J. ROGALSKI IS THE SON OF DR. EDWARD ROGALSKI, PAST CHAIRMAN OF GHS. 130650 EDWARD J. ROGALSKI RECEIVES COMPENSATION FROM GHS AS MERCER COUNTY HOSPITAL ADMINISTRATOR. 0 JW KOEHLER ELECTRIC INC JAMES W. KOEHLER, A DIRECTOR OF GHS, OWNS KOEHLER ELECTRIC. 108475 GHS USES SERVICES PROVIDED BY KOEHLER ELECTRIC. 0 LISA ROGALSKI SEE BELOW IN PART V 99009 LISA ROGALSKI RECEIVES COMPENSATION FROM GHS AS THE DIRECTOR OF MATERIALS MANAGEMENT. 0 BARBARA P PARK BARBARA P. PARK IS THE DAUGHTER OF JUDITH PRANGER, KEY EMPLOYEE OF GHS. 50382 BARBARA P. PARK RECEIVES COMPENSATION FROM GHS AS A PHYSICAL THERAPIST. 0 ERIN E MOORE-WATERMAN SEE BELOW IN PART V 40792 ERIN MOORE-WATERMAN RECIEVES COMPENSATION FROM GHS AS A MEDICAL LIBRARIAN. 0 FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - WELLMARK HEALTH PLAN OF IOWA, INC. DOUGLAS P. CROPPER IS THE BOARD PRESIDENT/CEO OF GHS AND A DIRECTOR ON THE BOARD OF WELLMARK HEALTH PLAN OF IOWA, INC. FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - GENVENTURES, INC. MARK G. ROGERS AND ROGER A. HILL ARE OFFICERS, FLORENCE L. SPYROW IS A KEY EMPLOYEE, JAMES A. KOEHLER IS A DIRECTOR, AND MIKE SHARP IS A FORMER KEY EMPLOYEE OF GHS AND ARE REPORTED ON THE FORM 990, PART VII. DURING THE TAX YEAR, MARK G. ROGERS, ROGER A. HILL, JAMES W. KOEHLER, AND MIKE SHARP WERE OFFICERS OF GENVENTURES, INC., AND FLORENCE L. SPYROW WAS A DIRECTOR OF GENVENTURES, INC. FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - GREGORY J. BUSH GREGORY J. BUSH, THE TREASURER OF GHS, IS CHAIRMAN OF BUSH CONTRUCTION COMPANY INC. FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - ERIN E. MOORE-WATERMAN ERIN E. MOORE-WATERMAN IS THE DAUGHTER-IN-LAW OF C. DANA WATERMAN, DIRECTOR OF GHS. FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - HEALTH ENTERPRISES DOUGLAS P. CROPPER IS THE BOARD PRESIDENT/CEO OF GHS AND A DIRECTOR ON THE BOARD OF HEALTH ENTERPRISES. FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - NAVIGANT CONSULTING, INC. THOMAS A. GILDEHAUS IS A DIRECTOR OF NAVIGANT CONSULTING, INC. AND A DIRECTOR OF THE GHS BOARD. FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - LARSON CENTER PARTNERSHIP FLORENCE L. SPYROW IS A KEY EMPLOYEE OF GHS-IA AND THE VOTING REPRESENTATIVE IN THE LARSON CENTER PARTNERSHIP FOR GHS-IL, A PARTNER IN THE LARSON CENTER PARTNERSHIP. FORM 990, SCHEDULE L , PART IV, COLUMN B DESCRIPTION OF RELATIONSHIP - LISA ROGALSKI LISA ROGALSKI IS DAUGHTER-IN-LAW OF DR. EDWARD ROGALSKI, PAST CHAIRMAN OF GHS. FORM 990, PART VI, SECTION B, LINE 11 INTERNAL MANAGEMENT REVIEW IS COMPLETED OF THE COMPILED INFORMATION PRIOR TO PREPARATION AND REVIEW BY MCGLADREY LLP. FOLLOWING MCGLADREY LLP'S PREPARATION AND REVIEW OF THE FORM 990, IT IS REVIEWED WITH THE ORGANIZATION'S VICE PRESIDENT, FINANCE/CFO; VICE PRESIDENT, LEGAL AFFAIRS; AND VICE PRESIDENT, HUMAN RESOURCES. THE FORM 990 IS THEN REVIEWED AT A JOINT MEETING OF THE ORGANIZATION'S FINANCE COMMITTEE AND AUDIT & COMPLIANCE COMMITTEE. PRIOR TO SUBMITTING THE FORM 990 TO THE IRS, IT IS E-MAILED TO THE ORGANIZATION'S BOARD OF DIRECTORS ONE WEEK IN ADVANCE OF A SCHEDULED MEETING. AT THE BOARD OF DIRECTORS MEETING, INTERNAL MANAGEMENT REVIEWS THE FORM 990 WITH THE BOARD OF DIRECTORS. SUGGESTED CHANGES FROM ALL OF THESE REVIEWS ARE CONSIDERED FOR INCLUSION IN THE FINAL FORM 990 SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANY COVERED PERSON, DEFINED AS ANY DIRECTOR, OFFICER, OR MEMBER OF A BOARD OR BOARD COMMITTEE OF GENESIS HEALTH SYSTEM (GHS) OR AN AFFILIATE, SHOULD DISCLOSE AN INTEREST OR POTENTIAL INTEREST AS SOON AS THEY BECOME AWARE OF A POTENTIAL TRANSACTION THAT WILL BE CONSIDERED BY MANAGEMENT, THE BOARD, OR A COMMITTEE OF THE BOARD. COVERED PERSONS ARE REQUIRED ANNUALLY TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILY, OR BUSINESS RELATIONSHIPS THAT REASONABLY COULD GIVE RISE TO AN INTEREST OR CONFLICT INVOLVING GHS, OR AN AFFILIATE, OR WITH RESPECT TO DESIGNATED FACILITIES AND ACTIVITIES, AND ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS FAMILIAR WITH AND IS IN COMPLIANCE WITH THE LETTER AND SPIRIT OF THIS POLICY. ANY COVERED PERSON FOUND TO HAVE A CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING TO PRESENT INFORMATION AND ADDRESS ANY QUESTIONS RAISED BY OTHER DIRECTORS OR COMMITTEE MEMBERS. SAID PERSON SHALL NOT BE ALLOWED TO ACTIVELY AND AGGRESSIVELY ADVOCATE IN HIS OR HER OWN BEHALF NOR SHALL SUCH PERSON ADVOCATE HIS OR HER POSITION INFORMALLY THROUGH PRIVATE CONTACT, COMMUNICATION AND DISCUSSION WITH ANOTHER DIRECTOR. AFTER SUCH PRESENTATION, THE PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE APPLICABLE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15 EACH EXECUTIVE POSITION IS EVALUATED USING A FORMAL EVALUATION PLAN THAT IS ESTABLISHED BY AN OUTSIDE CONSULTANT. AT THE PRESENT TIME, THE CONSULTANT USES A POINT SYSTEM FOR JOB EVALUATION. THE POINT VALUES ARE BASED ON "KNOW HOW", "PROBLEM SOLVING", "ACCOUNTABILITY", AND OTHER JOB ATTRIBUTES SPECIFIC TO THE POSITION. ONCE THE POINT VALUE IS SET FOR A POSITION, MARKET COMPARISONS FOR JOBS WITH THE SAME ORGANIZATIONAL IMPACT CAN BE COMPARED FOR SALARY PURPOSES AND ESTABLISH PAY RANGES. THE DESIGN OF THE PAY RANGES FOR EXECUTIVES IS BASED ON MARKET DATA. THE MIDPOINT OF EACH PAY RANGE IS ESTABLISHED AT THE 50TH PERCENTILE OF THE MARKET COMPARISONS. A MINIMUM GUIDELINE IS ESTABLISHED AT THE 25TH PERCENTILE, AND A MAXIMUM GUIDELINE IS SET AT THE 75TH PERCENTILE. SPECIFIC PAY RATES FOR EXECUTIVES ARE SUBJECT TO CEO AND COMPENSATION COMMITTEE AND THE GHS BOARD OF DIRECTORS APPROVAL. PAY RANGES ARE REVIEWED EACH YEAR TO DETERMINE THE NEED FOR REVISION. WHEN MARKET CONDITIONS SUGGEST AN ADJUSTMENT TO PAY RANGES, DATA WILL BE PRESENTED TO THE COMPENSATION COMMITTEE FOR ITS REVIEW. THE SPECIFIC PAY RANGES ARE SUBJECT TO CEO, COMPENSATION COMMITTEE, AND GENESIS HEALTH SYSTEM (GHS) BOARD OF DIRECTOR APPROVAL. THE PRESIDENT AND CEO HAS THE AUTHORITY AND RESPONSIBILITY TO ESTABLISH AND ADJUST, WITHIN THE RANGE APPROVED BY THE COMPENSATION COMMITTEE AND THE GHS BOARD OF DIRECTORS, THE BASE COMPENSATION OF EACH EXECUTIVE EMPLOYED BY GHS, AT APPROPRIATE TIMES. THE GHS BOARD OF DIRECTORS SHALL ESTABLISH AND ADJUST, WITHIN THE RANGE APPROVED BY THE COMPENSATION COMMITTEE, THE BASE COMPENSATION FOR THE CEO OF GHS, AT APPROPRIATE TIMES. THE LAST TIME THIS PROCESS WAS FORMALLY UNDERTAKEN WAS NOVEMBER 2012. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,731,787. CHANGE IN FUNDED STATUS OF RETIREMENT -15,464,620. CHANGE IN NET ASSETS OF FOUNDATION 109,853. TOTAL TO FORM 990, PART XI, LINE 5: -17,086,554. FORM 990, PART XII, LINE 2C THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR. FORM 990, PART VII, LINE 1A GENESIS HEALTH SYSTEM, EIN 42-1418847, AND GENESIS HEALTH SYSTEM, EIN 36-3616314 HAVE IDENTICAL GOVERNING BOARDS AND AN IDENTICAL EXECUTIVE MANAGEMENT TEAM. THE HOURS REPORTED ON FORM 990, PART VII, SECTION A, COLUMN (B) REPRESENTS THE NUMBER OF HOURS THESE INDIVIDUALS DEVOTE TO BOTH ORGANIZATIONS. FURTHERMORE, THE AMOUNTS REPORTED AS REPORTABLE COMPENSATION FOR THE OFFICERS, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES, UNLESS OTHERWISE NOTED ELSEWHERE IN PART VII, ARE FOR SERVICES RENDERED ON BEHALF OF BOTH ORGANIZATIONS. IT WOULD BE ADMINISTRATIVELY IMPRACTICABLE FOR MEMBERS OF THE GOVERNING BOARD AND THE EXECUTIVE TEAM TO BREAKOUT THEIR HOURS DEVOTED AS WELL AS THEIR REPORTABLE COMPENSATION BETWEEN EACH ORGANIZATION. ALL REPORTABLE COMPENSATION, UNLESS OTHERWISE NOTED IN PART VII, IS PAID BY GENESIS HEALTH SYSTEM, EIN 42-1418847. 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